Coronary pressure measurement has emerged over the last few years as a major step forward in the invasive assessment of coronary artery disease. This was due on the one hand to major technical progress in developing pressure-monitoring guide wires, and on the other to a theoretical innovation, the concept of coronary pressure-derived fractional flow reserve, which closely relates distal coronary pressure to myocardial blood flow during maximum arteriolar vasodilation. In the catheterization laboratory, this new approach enables an "on-the-spot" diagnosis as to what extent a given epicardial stenosis contributes to reversible myocardial ischemia and the decision as to whether revascularization of the stenosis is warranted or not. In addition, pressure-derived fractional flow reserve appears to be a useful index in monitoring and guiding coronary intervention, including stent deployment. In "Coronary Pressure", the theoretical and physiological background of this approach is systematically reviewed and advanced clinical applications are illustrated, for both diagnostic and interventional catheterization, including tips, tricks, and potential pitfalls of this approach.
This book caters for two types of reader: first, as a guide to the interventionalist who wants to make a quick start; and second, for cardiologists, radiologists, physiologists, and fellows in training for those specialties, who would like to understand the most recent progress in the field of invasive functional assessment of coronary artery disease. This book is an aid to the understanding and treatment of coronary artery disease and could be a major influence on practice in the catheterization laboratory in the next decade. index